• Fabio Nicoli, Daniel B Saleh, Bence Baljer, Corey D Chan, Tom Beckingsale, Kanishka M Ghosh, Maniram Ragbir, and Kenneth S Rankin.
• Department of Plastic and Reconstructive Surgery, Royal Victoria Infirmary Hospital Newcastle NHS Foundation Trust, Newcastle upon Tyne, UK.
• Ann. Surg. 2021 Feb 1; 273 (2): e63-e68.

BackgroundComplete excision of sarcomas to maximize function without compromising the oncological outcome can be challenging. The aim of this study was to investigate the feasibility and potential drawbacks of near-infrared (NIR) fluorescence imaging with indocyanine green during resection of bone and soft tissue sarcomas.MethodsEleven patients with high-grade sarcomas were enrolled in the study. All patients received intravenous indocyanine green (75 mg) between 16 and 24 hours before the resection. Sarcomas were resected under NIR guidance and specimens were sent for routine histopathological analysis.ResultsMajority of treatment naive tumors demonstrated fluorescence. There were no adverse events from the indocyanine green administration. In 3 cases, the fluorescence was reported by the surgeon to have been of definite guidance leading to further tissue resection to improve the margin.ConclusionThis is the first report of NIR fluorescence guidance in the setting of open sarcoma surgery. The technique is acceptable to patients and surgeons and was able to guide resection. Multicenter studies are required to assess the utility of this technique in a large cohort of patients with regards to quantification of fluorescence, resection guidance, and longer follow-up period.Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

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